AXIS Imaging Interview: Four Options for Image-Display Architecture: A Deep Dive

How diagnostic images get from server hard drives to the screen is a topic of great interest to both industry and buyers of imaging IT solutions. Speed of image access is critical for quality of service and care, along with productivity and user satisfaction.

Different solutions take different approaches to optimize image delivery over varying networks. Many solutions combine more than one software design method to achieve the best possible performance. In many cases, industry or buyers will use jargon, like “streaming”, to apply a simple term to these sometimes complex technical methods.

In a recent article by AXIS Imaging, I describe four common techniques that are used in (and occasionally between) different imaging IT systems to maximize image display speed. The article length limit prevented coverage of additional methods and intentionally excluded IT infrastructure optimizations (for example, faster networks, CPUs, and drives) and the use of irreversible lossy image compression of the images on disk.

Important Article Corrections

Although I followed up with the author about some transcription errors they made in preparing the article language, they were not corrected (at least at the time of posting this), so I am going to note some corrections here.

  1. Where the article states “…radiology practices and departments have options when designing high-speed image display…”, it should state “…radiology practices and departments have options when choosing the solution for high-speed image display…”. Radiology practices choose a solution and that solution will use one or more of the design methods (or additional ones not listed), but the Radiologists don’t choose the methods within the solution.
  2. In subsection #3, the second bullet refers to a condition where pre-caching is typically not possible (the article states the opposite). If the worklist is a separate application from the image display application, the image display application often has no method of knowing which exams listed are in the worklist, so is unable to pre-cache the images to the workstation. This is not always true, as some worklist applications can expose this information to the image display application through an API, but this is not a universally available capability and does require that a specific integration be developed to support this across the applications.
  3. In subsection #4, where it states “visual design infrastructure”, it should instead state “virtual desktop infrastructure”. People commonly refer to it as VDI.

SIIM19 – Will I See You There?

In less than two weeks, the SIIM Annual Meeting will be taking place at the newly opened Gaylord Rockies Resort in Aurora, Colorado. I am looking forward to catching up with old friends and meeting new ones, along with learning lots of new information.

This year, I am (co-)chairing three sessions and participating in a fourth. Here is a summary (my role). All times are in local MT.

If it is your first annual meeting, I recommend you go to the First Time Attendee Meet-up on Tue 25-Jun at 6:15 pm in the Adams C/D Lobby room and attend the New Member Orientation: Intro to SIIM session on Wed 26-Jun at 9:45 am. Jim and Rick are great educators and mentors.

Also, be sure to check out the pre-conference sessions, the Hackathon and Innovation Challenge events, as well as the #AskIndustry, Learning Lab, and Scientific sessions. And be sure to put the SIIM 2019 Reception on your calendar. It is great to connect with peers and review the scientific posters.

While you are on-site, don’t forget to share information and activities (and selfies!) using the SIIM Twitter handle @SIIM_Tweets (remember to follow SIIM for great info on imaging informatics throughout the year!) and the official 2019 Annual Meeting hashtag: #SIIM19.

I hope to see you there!

SIIM 2018 Annual Meeting: A Preview

SIIM18 graphic
Gaylord National Resort, National Harbor, MD

The SIIM 2018 Annual Meeting in Washington D.C. is just around the corner (May 31 to June 2). I look forward to seeing many friends, sharing ideas, and learning. I will be involved in number of sessions this year. Here is a preview.

Preparing for a Successful RFP and Contract with Vendors

Thursday, May 31 | 9:45 am – 10:45 am | Annapolis 1

In this roundtable session, participants will discuss how to best prepare for, develop, and issue an RFP, as well as how to analyze and grade the responses. We will also discuss how to best prepare for, and support, contract negotiations with a vendor.

Debate: Enterprise PACS vs. Vendor Neutral Archive (VNA): Choose Wisely

Friday, June 1 | 9:45 am – 10:45 am | Cherry Blossom Ballroom

Depending on your organization’s goals and scale of enterprise, the options available to you for an image archive can vary. In this debate-style session, we will explore the merits of using a Vendor Neutral Archive (VNA) vs. an archive provided as part of an Enterprise PACS. I am moderating the session.

Imaging IT Financials – Learn from the Masters

Saturday, June 2 | 12:45 pm – 2:45 pm | Baltimore 3/4/5

Participants that sign up for this learning lab (limited seats available) will work hands-on with experts to learn how to perform clear and compelling financial analysis. Two lab exercises—one focused on assessing cloud-based vs. on-premises image archive storage, and another on the IT investment required for rolling out the enterprise imaging solution to a newly acquired facility—will be worked on in teams. Each team will share their work with the other near the end of the session. Lab assistants will be on-hand to assist. Participants must bring a laptop or tablet with Microsoft Excel installed.

 

SIIM 2017 – Economics of Imaging Informatics

I feel fortunate to chair a very interesting and relevant session during the SIIM 2017 annual meeting this week. The session will focus on the following areas, which are often discussed with clients and industry colleagues.

It seems that there is no well-defined formula or consensus regarding the staffing levels and the structure of an Imaging Informatics Team (IIT). Typical questions are:

  • How large should an IIT be, given the annual Radiology exam volume and number facilities the team supports?
  • In the era of EMRs and IT centralization, what is the right mix of roles between IIT and Corporate IT?
  • How does IT centralization affect IIT financial decision-making and budgets?

James Forrester’s talk will address the above topics, based on his experience at University of Rochester Medical Center.

Another interesting observation is that typically outside of the Director of IIT role, IIT members lack understanding of corporate finance. Even though most significant projects must be budgeted for in advance and any innovation or improvement proposal must be accompanied with a well-crafted business case. Robert (Bob) Coleman’s talk will provide an overview of proven budgeting methods, core components of a good business case, and the required skills to prepare one.

You may also wish to check out this interactive, whiteboard session, which will walk through some common financial models used to evaluate the Total Cost of Ownership (TCO) and Return on Investment (ROI) for imaging IT projects when talking to the CIO.

Looking forward to seeing everybody in Pittsburgh!

SIIM 2017

The Society for Imaging Informatics in Medicine (SIIM) annual meeting will be held on Thu June 1 to Sat June 3, 2017 in Pittsburgh. It has a great program, and by all early accounts, will be one of the best attended in years. See the complete program here. Register to attend here.

Genady and I will be participating.

don-headshot-round

Don K Dennison

Weighing the Options: Enterprise PACS vs. VNA for Enterprise-wide Archiving

Thursday, June 1 | 3:00 pm – 3:30 pm
Science & Innovation Pavilion | Exhibit Hall Theater
#AskIndustry Session

Sharing an imaging archive is generally a good thing, but should you implement one archive and connect multiple PACS and other imaging IT systems to it, or should you build an Enterprise PACS and consolidate your various PACS into it? We will get the perspective of vendor staff that are faced with these types of questions from their customers.

TCB: TCO to the CIO for the CIIP

Friday, June 2 | 8:00 am – 9:30 am
Room 301-302
Whiteboard

The ability of a CIIP to accurately model the Total Cost of Ownership (TCO) for imaging IT application investments and operating costs are critical to getting the support of the CIO, and to getting necessary funding.

In this interactive whiteboard session, “Taking Care of Business: Total Cost of Ownership to the Chief Information Officer for the Certified Imaging Informatics Professional”, attendees will be walked through two scenarios — Multiple PACS Replacement and Consolidation and Cost Model for Shared Enterprise Imaging Platform — by faculty experienced in financial analysis and cost model development.

Combining whiteboard discussion and review of some predefined spreadsheets that provide important calculations for each scenario, this session is intended to be highly interactive with Q&A throughout. The spreadsheets used in the session will be made available to members on the SIIM website following the annual meeting.

genady-headshot-round

Genady Knizhnik

Economics of Imaging Informatics

Friday, June 2 | 4:15 pm – 5:15 pm
Pittsburgh Ballroom B
Core Topic Session

Imaging informatics teams routinely embark on new projects and have to support their operations, which depend on the right budget. Budget preparation and justification skills, as well as understanding of the right size and structure of the operational team, are important for securing required financial support. Attendees will examine the fundamentals of preparing well-defined budget requests that CIOs are looking for, as well as how to structure and staff the optimal imaging informatics team.

SIIM 2016: Where’s Don

SIIM2016

SIIM 2016 is almost here. If you are attending this year’s Annual Meeting, you may find these sessions that I am chairing of interest.

Developing an Imaging Record Quality Policy
Thursday, June 30 | 1:15 pm – 2:45 pm
Portland Ballroom 256

Strategies and Tactics for Capturing and Sharing Images
Friday, July 1 | 8:00 am – 9:30 am
Portland Ballroom 256

Strategies for Dealing with Patient Identities in a Consolidated Enterprise
Friday, July 1 | 1:15 pm – 2:45 pm
Portland Ballroom 256

Basically, just park yourself in Portland Ballroom 256 and I will come to you.

I will also be participating in the:

Hackathon Project Showcase (#SIIMHacks)
Friday, July 1 | 9:45 am – 10:45 am | Portland Ballroom 254

I look forward to catching up with some old friends and making some new ones over some craft beer!